1983, 04-08 Permit: 83A-2763 PlumbingIUMBER APPL ICAT ION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
TO
PHONE
N. 3306
C72_7-, _75
LOT
BLOCK
SUBDIVISION
2.
LICENSE EXPIRES
I
I
OD
la
OWNER
ZIP
3.
OSCA?- i.Jlh►GE.�
MAILING ADDRESS
N - 3 3o o,
ce_wm ?
CONTRACTOR
4.
SA1wrk—
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
TO
PHONE
PHONE
C72_7-, _75
MFG.Home
ZIP
/S&4F—
Other (Specify)
�I°IZD
LICENSE EXPIRES
PHONE
TOTAL $
OD
la
ZIP
PHONE
ZIP
TYPE ❑ NEW O"ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ BLD. {A-RCMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER
Actual Set CaCKs In Feet to:
North South East West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation Remodeled Valuation I Total Bldg. Floor Area
Main Floor I Upper Floors I Garage/ Storage I Greenhouse
Cover Deck Uncv. Deck FIn. Basement Unfin. Basement
No. Baths No. Floors No. Fin. Rooms No. Dwellings
WORK or
of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
8• nil— Yes❑ Not Applic. ❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLICO SEPTIC 0 Ownership FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REV IDE FOR REQUIRED INSPECTIONS
SIGNATURE OF 9< APPLICATION
OWNER OR AGENT-- DATE
SPECIAL APPROVALS SPEC CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
( GZ-aSGrl"
Planning si--
Plans i I PERMIT IS NONTRANSFERABLE
Exam' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Building
Plumbing
Mach.
Plan Check
iz °
SEPA
Modular/
MFG.Home
/S&4F—
Other (Specify)
00
5-11-,
TOTAL $
OD
la
WHEN MACHINE VALIDA7
THIS
(�BECOMES A PERMIT.
DATAk" 813'
PERMIT NUMBER
,?3A -2--7r.3
03* *17,00
* 1 7.00
*17.0010
A *0,00 00
27622
04-08-83
2 6479,
PERMIT�O. 6 3 2 k 1' 7' O' 0 *61T41.